The Times Magazine 33identity to get out of loving me, Cliff!” she
shouted, her eyes beginning to water. (At
that point, I had to call for a female carer
to supervise. When I explained the situation,
duly mortified, she found it very funny.)
But even though she has these delusional
episodes, she retains plenty of day-to-day
information: who the carers are, information
about our lives, conversations we’ve had. And
she recognises me (most of the time), and
always says she’s relieved when I’m on a shift,
and refers back to anecdotes I’ve told. But still,
there are gaps in her knowledge: she usually
knows me as “Paul”. (I’m always correcting
her on this but “Pope” never sticks.) And in
my spare time, I’m apparently restoring a
19th-century steam locomotive.
“How’s the train coming along, Paul?”
asks Susan. “Getting there! Just mending the...
tubes... of steam,” I reply, failing to summon
any convincing railway terminology.
It’s important to demonstrate engagement
with a resident and stay close, in case their
hearing fails them. Sometimes considering
any heavy subject matter, I affect an almost
pious bearing. But if the situation requires it,
I switch gears. I can gossip! I actually had a
subscription to Heat at one time. Sometimes
Susan and I will look at “scandalous” celebrity
outfits and she’ll ask, “Would your wife wear
that?” (I haven’t got a wife. I haven’t got a
train. What the f*** am I doing?) This is a
good example of the social involvement that
helps to improve a resident’s well-being. It
doesn’t have to be elaborate.
Whenever I’m speaking or writing about
elderly care, I try to avoid sentimentality. All
it does is provide a palatable version of ageing
that is unhelpful. The knock-on effect is this:
when a member of the public is presented
with, say, coprophagia (the eating of faeces) or
libidinous behaviour from a relative who used
to be a nun (yes, really – I’ll leave the details
to your imagination), it can be too much. And
when people reach their limit, they tend to
look away, which leads to neglect. I’ll go as far
as to say that I find saccharine representations
of care homes moderately unethical.I give Simon, in room 2, a quick wave as
I walk past. (He doesn’t see me. He’s too busy
steadying a miniature bottle of Jameson as
he pours it into his coffee. If you catch him
in the morning, you’ll find him pouring it onto
his cornflakes.) Simon and I once shared a
sneaky Irish coffee while I was working on
my birthday. I didn’t realise how much he’d
poured in. He sat on his chair; I sat on the
edge of his bed. The mixture of alcohol and an
overheated room put us both to sleep – and
I woke up slumped to the left, my forehead
pressing into the edge of the headboard.Continues on page 45pad and clean bed are then spoiled by a
leaking resident. But this pride is in stark
contrast to the dump ’n’ run approach of some
of the lazy pricks I have encountered. They’ll
even throw a duvet over damp urine stains.
In the staff room there’s a new memo on
the wall-length pinboard, divided into two
columns: “Things You Might Say About A
Client/Things You Should Say Instead”. The
first example: “Mrs Lady is mental/Mrs Lady
has frontotemporal dementia”. To be told how
to speak is one of many little indignities at the
hand of unwanted corporate paternalism that
chips away at you. With this memo there’s an
insinuation from “upper management” that we
can’t be trusted to have a conversation with
another person without a script. It turns carers
into automatons – which is how most of upper
management sound during site visits anyway,
crouching in front of residents and talking
to them with a patronising tilt of the head.
I remember one of them once strode into our
dining room wearing a three-piece suit and
asked, “Is everyone having a safe afternoon,
ladies and gentlemen?”
The fixation on profit has been disastrous
for the care sector – and even the most trivial
and petty acts of insubordination can have
a positive impact on a work shift. I don’t care
what the company directors say. We won’t be
using peanut butter sparingly! I’ll turn lights
on when I’m leaving the room! I’ll make sure
I hit every corner when transporting food or
medicine trolleys! I’ll take up smoking just so
I can do it near an oxygen tank!
It usually takes about two hours to finish
breakfast as transferring 22 residents from
room to room is demanding. Approximately
a dozen of these need to be hoisted, three
are bed-bound, and the remainder require
a walking aid plus a carer to supervise them.
Almost everyone needs help being taken
to the toilet. Nine of them are assisted with
their food. There are also catheters to empty,
incontinence pads to change, arguments to
break up, a few remaining beds to be made,
family members to appease, a dining room to
be cleaned and organised in preparation for
lunchtime, dishes to be washed and dried (by
hand), wounds to be redressed, drinks to be
topped up, more teas to be made... The list
goes on. When there are only two carers and
one resident needs to go to the toilet the
remaining carer is unable to leave the lounge,
where the majority of the residents are sitting,
in case one tries to stand up and takes a
tumble. It’s a constant game of Whac-A-Mole.
Once all the loose ends have been tied up,
that’s when we can start the paperwork.
I overhear Susan calling out. She looks tanned
and healthy. Her teeth are her own. And
she still wears clothes for style as well as
comfort. Some sequins, some lace, some
off-the-shoulder numbers. A young-ish old.
“Marvellous for her age.”
She’s married to Cliff, who, like his wife, is
a healthy-looking 80-year-old. Tall and broad-
shouldered. A former wrestler. And he, too,
has a deep tan. I always imagine them as
characters in a John Updike novel – having
never read a single John Updike novel. But
he’s clearly devoted to his wife and makes the
effort to visit her every day after lunch.
She had a stroke a few years back that left
her paralysed on one side of her body. Her
right hand is permanently clenched – and so
tightly that her fingernails are embedded in
her palm. She was given a “therapy carrot” (a
carrot-shaped cushion that’s inserted into the
hand) to pry the fingers away from the palm
and prevent puncturing. But carers often
forget to put it in place. It’s a small oversight
but one with knock-on consequences. Dirty
nails. Open sores. Initial discomfort leading
to the pain of swollen fingers. And, finally, the
smell that confirms infection. By that point,
you’re nothing but the smell. And Tracy- tactless, irresponsible Tracy, one of the
other carers – will hold her nose around you.
Susan’s dementia has made her paranoid.
She’s always worried Cliff’s cheating on her.
Or that he hasn’t come to visit. Or assumes
the other residents are conspiring against her.
As a result, she cries a lot and throws around
accusations. On one occasion, as I was
assisting her onto the toilet, she responded
curtly to my small talk.
“What’s up, Susan?” I asked. “What have
I done to annoy you?”
“Oh, you know what you’ve done,” she
replied, turning her head away.
“I really don’t know! Let me know and
I can try to rectify it.”
She banged her fist against the railing next
to the toilet, like a stroppy toddler.
“I want you to have sex with me, Cliff! Is
that too much to ask? I want you to want to
have sex with me.”
I was shell-shocked.
“God, no! Susan, no! No, no, no. I’m not
Cliff. I am not your husband,” I exclaimed.
“I’m Pope. I’m your carer.”
“You don’t have to make up a whole new
44 PER CENT OF CARE
HOMES DON’T EMPLOY ANY
AGENCY STAFF TO COVER
STAFF SHORTAGES